KEVIN W RIDDLEBERGER P.A. NPI 1396745683

NPI Information

  • NPI: 1396745683
  • Provider Name: KEVIN W RIDDLEBERGER, P.A.
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • Address: 1551 PROFESSIONAL LN
    SUITE 200
    LONGMONT, CO
    ZIP 80501
  • Phone: (303) 772-1600

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NPI Details

Kevin W Riddleberger, P.A. is a surgical physician assistant in Longmont, CO. Kevin W Riddleberger, P.A. NPI is 1396745683. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1551 PROFESSIONAL LN
SUITE 200
LONGMONT, CO
ZIP 80501-972
Phone: (303) 772-1600
Fax: (303) 772-9317

The enumeration date for this NPI number is 7/28/2005 and was last updated on 11/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant1801COLORADONo
2363AS0400XPhysician AssistantSurgical1801COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Q02307MEDICARE UPIN
2809242MEDICARE PINCOLORADO
354570867MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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